When Valerie Maholmes, Ph.D., was young, she observed the power of a girl’s bond to her abusive mother (see italicized text below). Dr. Maholmes didn’t know it at the time, but it was her first step to a career focusing on childhood abuse and neglect.
Dr. Maholmes oversees the Pediatric Trauma and Critical Illness Branch (PTCIB). She explains why she changed her early plans to be a television news reporter to pursue the career that brought her to the NICHD.
Q: What are the goals of the Pediatric Trauma and Critical Illness Branch and the Child and Family Processes and Maltreatment/Violence Research Program you head?
Dr. Maholmes: The main goals are to make sure that children are healthy and wanted and have the opportunity to live to their potential.
So for Child and Family Processes, we want to make sure that children are placed on an optimal developmental course, and our research is helping to illuminate what has to happen to ensure that children have safe passage from early childhood through adulthood.
In the Pediatric Trauma and Critical Illness Branch, we research the kinds of medical treatments and interventions that children must have to make sure that they are able to survive critical illness and injury and have good quality of life. It could be from intentional or unintentional injuries; it could be from illness; it could be due to abuse and neglect. We’re also including effects of natural disasters in that research portfolio.
Q: How long have you been at the NICHD?
I started April 1st, 2005, 9 a.m. At the time, I held an endowed chair in social policy as an early-career faculty member at the Yale Child Study Center. I was going to come to Washington and change the world for children and families.
Q: What got you interested in this field?
I started out wanting to be a broadcast journalist. But while I was on my way to “fame and fortune” in broadcasting, my first job was as an admissions officer at a small college. What I learned was that there were [youth] wanting to come to college from inner city communities and rural communities, who were really good students, had good high school [grade-point averages], but were reading on eighth- and ninth-grade levels on standardized tests.
At that time, my theory was that there was something about the psychometric properties [the design, administration, and interpretation] of standardized tests that created these disparities, and that led to other kinds of disparities economically, and in health, and in quality of life.
I later did my postdoctoral work at the Yale Child Study Center, and they focus very much on how the context of one’s life informs and influences behavior and cognition and emotion regulation. You can’t look at the child’s achievement in isolation and say that child is not doing well in school because they are intellectually inferior. And of course, for minority children, that was the operating theory, the presumptive model at the time.
In thinking about the context of children’s lives, I thought about policy. I thought that it would be important to understand policy and how all of that worked together. So that led me here.
Listen to Dr. Maholmes talk more about context in children’s lives
Q: You oversee a large research portfolio. What are the most important or interesting findings to come out of your programs in the last 5 years?
There are some papers coming out now which show links between early adversity and some health outcomes. A study by grantee Dr. Gene Brody at the University of Georgia is really important. It’s an intergenerational study looking at the impact of the stressors of living in rural poverty. [PMID: 22709130]
The study looks at what we call “allostatic load,” the physiological toll that stress takes on the body. They have found that it takes a physiological toll on families to press forward, to be resilient, and to do all of those things that help promote quality of life. It’s just a fascinating study that can inform how we think about resilience and what the implications are of trying to promote resilience, especially for families that are managing so much adversity. What are the policy implications for families who are living in that kind of poverty? How did they overcome some of these obstacles to break the cycle of poverty, to help their children take advantage of resources, do well academically, and engage in a career or a work environment in a way that they can have success and break that cycle of poverty?
But at the same time, while families are resilient, we also need to recognize that it is really difficult and that it does take a toll. People need support throughout their life, and I think that’s an important finding. And even if they appear to be successful and resilient, they need that support.
Hear more about the connection between childhood adversity and health
Q: How does your life outside the office inform your work?
Well, it’s funny because I do in private life what I do in my work life. I’m involved in organizations that are service-oriented and that care for disadvantaged youth and families. I’m involved in educational organizations that help to strengthen cultural identity and purpose, and that help support fellowship and spiritual development. You have to put yourself in a position to give back.
My mission in life is to help, where I can, children and families that are less fortunate. I really absorb myself in those kinds of efforts.
Q: Was there something about your family values that prompted you to want to do this work?
The idea of helping and extending yourself to help others is part of my culture and my family culture. When I was a little girl, my parents took in foster children. So between the time I was 10 and 17, we probably had about seven or eight foster children that came through our house.
That was the best education I could have ever had because it taught me about issues of attachment. There was a child who had been abused and we got her from the hospital, but she loved her mother so much despite that abuse. Even I, as a young child, could see the distress of this little girl wanting to be with her mother and her siblings and not with these strange people who had these welcoming, open arms. So there’s something so powerful about that relationship between the parent and the child, and that’s really what got me started and looking at that.
The fact that my parents would extend themselves to do that just, I think, I internalized that and just really wanted to be sure that children are safe and protected, and I think there is a bit of that underlying the choices that I made in terms of my career.
Q: Speaking of attachment and bonding, NICHD has been funding research regarding separations in military families and the effect of these separations on children.
We started that initiative almost 2 years ago, calling for research on children of military families, and focusing in particular on the impact of multiple separations through deployment. We really wanted to know how it affected the child and family functioning. So we’re getting research in now that’s looking at what happens when a military parent comes home and has to reintegrate with the family. How does a child respond to a parent who is now somewhat different? How does that affect the parent-child relationship in the way that the family functions?
We’re also looking at, if the mother is the one who’s deployed, what happens to that attachment bond. Is the child able to develop social relationships and bond with that parent despite the fact that they may be away during critical developmental times for that child?
Q: Do we know the answer to that yet?
We are still looking at that, but what we know just from the general attachment literature is that certainly there are ways to maintain that bond. What a lot of families do is to stay in constant communication through technologies like Skype™ that allow the child to hear the parent’s voice and to see the parent’s face.
But until we have longitudinal studies of those kinds of early separations and multiple early separations, we won’t know what impact they’ll have on the parent-child relationship and the child’s ability for social engagement and bonding.
But where there is an extended family—there’s a grandmother, or aunt, or an older sibling that can help mitigate some of the negative effects of these multiple separations—I think we are inclined to see more positive outcomes. But in families where there might have been some pre-existing dysfunction, we certainly would expect to see poorer child outcomes in these situations.
One of the things that we do know is that there’s a great deal of resilience in military families, especially those active duty families. There are a lot of resources that they have available to them, in many cases, and those families build social networks among themselves. And so, they have ways of ameliorating the stressors of being in a military family, whereas civilian families may or may not have those kinds of resources.
We’re still looking at the National Guard and Reserve, the civilian soldiers, because they are less likely to have those kinds of resources and support available to them.
Hear Dr. Maholmes describe the NICHD letter-writing campaign to military families
Q: Could we talk about cyberbullying?
Well, it’s interesting because with bullying in general, the idea is that it’s a relational issue. It’s a power imbalance that there is some child who is vulnerable and that there are other youth and peers who find out about this vulnerability and take advantage of this child. With the electronic aggression or cyberbullying, we don’t know as much about that power imbalance.
But with this electronic aggression, children are being aggressed against on social media, through text messaging, and so forth, and the effects are really just alarming.
I should say that it affects the emotional stability and regulation of the child because you don’t have a sense of control over it and you often don’t know who the aggressor is. The stress of having that kind of experience that you can’t control, you don’t know where it’s coming from, who’s doing it, or why, is very hard for a young person to manage, especially adolescents.
So it’s really an important new area of inquiry for us. We need many, many more studies to really understand it, to look at how it’s similar and different from the physical bullying and who the cyberbully might be. Is there a typical profile of a cyberbully? We don’t know. There is some discussion about that, but we really don’t know.
Q: Do you have any hobbies?
I do have many hobbies. I started doing recordings for the blind when I was at Yale. When I moved here, I was looking for another opportunity to do that and happened to take a course on voiceovers. Since then, I worked with Dr. Florence Haseltine [former Director of the NICHD Center for Population Research, currently a special consultant to the NICHD] providing the voiceover for a reproductive training video, which was a lot of fun.
So this is kind of getting back to my early broadcasting interests. I would love to, at some point in my career, bring all of that together, the research and policy, through a career in broadcasting. It’s a dream I have.
Q: The subject matter you deal with can be very intense. How do you deal with that?
My health strategy is that I have one good belly laugh a day, regardless, because most of the work that I do and have done over the course of my career has been with disadvantaged children or children in adversity or children in some kind of difficult circumstances. And so, it can be kind of daunting, and if you’ll allow it to be, it can be very emotionally draining. So you have to have a laugh.
For more information on the work of the PTCIB and the CDBB, please review the following links: